Ömer Hatipoğlu, João Filipe Brochado Martins, Mohmed Isaqali Karobari, Nessrin Taha, Thiyezen Abdullah Aldhelai, Daoud M Ayyad, Ahmed A Madfa, Benjamin Martin-Biedma, Rafael Fernández-Grisales, Bakhyt A Omarova, Wen Yi Lim, Suha Alfirjani, Kacper Nijakowski, Surendar Sugumaran, Xenos Petridis, Silvana Jukić Krmek, Dian Agustin Wahjuningrum, Azhar Iqbal, Imran Zainal Abidin, Martha Gallegos Intriago, Yasmine Elhamouly, Paulo Jorge Palma, Fatma Pertek Hatipoğlu
{"title":"Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational Cross-Sectional Study With Meta-Analysis.","authors":"Ömer Hatipoğlu, João Filipe Brochado Martins, Mohmed Isaqali Karobari, Nessrin Taha, Thiyezen Abdullah Aldhelai, Daoud M Ayyad, Ahmed A Madfa, Benjamin Martin-Biedma, Rafael Fernández-Grisales, Bakhyt A Omarova, Wen Yi Lim, Suha Alfirjani, Kacper Nijakowski, Surendar Sugumaran, Xenos Petridis, Silvana Jukić Krmek, Dian Agustin Wahjuningrum, Azhar Iqbal, Imran Zainal Abidin, Martha Gallegos Intriago, Yasmine Elhamouly, Paulo Jorge Palma, Fatma Pertek Hatipoğlu","doi":"10.1111/jerd.13321","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This web-based survey, conducted across multiple countries, sought to explore the factors that impact the decision-making of clinicians when it comes to managing defective direct restorations.</p><p><strong>Methods: </strong>A survey consisting of 14 questions was sent out to dentists in 21 countries through various online platforms. The survey consisted of two sections. The first contained five questions about demographic information, while the second involved eight clinical scenarios. In the second part, participants were tasked with deciding whether to repair or replace defective composite and amalgam restorations.</p><p><strong>Results: </strong>Three thousand six hundred eighty dental practitioners completed the survey. For composite restorations, repair was preferred in scenarios like partial loss or fracture (RR:0.72; 95% CI: 0.58, 0.89; p = 0.002), whereas replacement was favored for secondary caries (RR:2.43; 95% CI: 1.87, 3.16; p < 0.001) and open/defective margins (RR:3.93; 95% CI: 2.68, 5.76;p < 0.001). Amalgam restorations were mostly replaced across all scenarios. The main factors influencing decision-making were caries risk, restoration size, and patient oral hygiene. Substantial heterogeneity was observed across countries.</p><p><strong>Conclusion: </strong>This study underscores the complexity of the decision-making process and the need for evidence-based guidelines to inform clinicians' decisions regarding restoration management. Patient-level factors predominantly influence decision-making, emphasizing the need for individualized approaches.</p><p><strong>Clinical significance: </strong>The study reveals that the material type in the original restoration is a critical determinant, with composite restorations being repaired in specific scenarios, while amalgam restorations are consistently replaced across different countries. Key patient and tooth-level factors, such as high caries risk, poor oral hygiene, and restoration size, significantly impact clinicians' decisions, often favoring replacement over repair. These findings underscore the necessity for evidence-based guidelines to assist clinicians in making informed choices, ultimately enhancing the quality of patient care.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Esthetic and Restorative Dentistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jerd.13321","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This web-based survey, conducted across multiple countries, sought to explore the factors that impact the decision-making of clinicians when it comes to managing defective direct restorations.
Methods: A survey consisting of 14 questions was sent out to dentists in 21 countries through various online platforms. The survey consisted of two sections. The first contained five questions about demographic information, while the second involved eight clinical scenarios. In the second part, participants were tasked with deciding whether to repair or replace defective composite and amalgam restorations.
Results: Three thousand six hundred eighty dental practitioners completed the survey. For composite restorations, repair was preferred in scenarios like partial loss or fracture (RR:0.72; 95% CI: 0.58, 0.89; p = 0.002), whereas replacement was favored for secondary caries (RR:2.43; 95% CI: 1.87, 3.16; p < 0.001) and open/defective margins (RR:3.93; 95% CI: 2.68, 5.76;p < 0.001). Amalgam restorations were mostly replaced across all scenarios. The main factors influencing decision-making were caries risk, restoration size, and patient oral hygiene. Substantial heterogeneity was observed across countries.
Conclusion: This study underscores the complexity of the decision-making process and the need for evidence-based guidelines to inform clinicians' decisions regarding restoration management. Patient-level factors predominantly influence decision-making, emphasizing the need for individualized approaches.
Clinical significance: The study reveals that the material type in the original restoration is a critical determinant, with composite restorations being repaired in specific scenarios, while amalgam restorations are consistently replaced across different countries. Key patient and tooth-level factors, such as high caries risk, poor oral hygiene, and restoration size, significantly impact clinicians' decisions, often favoring replacement over repair. These findings underscore the necessity for evidence-based guidelines to assist clinicians in making informed choices, ultimately enhancing the quality of patient care.
期刊介绍:
The Journal of Esthetic and Restorative Dentistry (JERD) is the longest standing peer-reviewed journal devoted solely to advancing the knowledge and practice of esthetic dentistry. Its goal is to provide the very latest evidence-based information in the realm of contemporary interdisciplinary esthetic dentistry through high quality clinical papers, sound research reports and educational features.
The range of topics covered in the journal includes:
- Interdisciplinary esthetic concepts
- Implants
- Conservative adhesive restorations
- Tooth Whitening
- Prosthodontic materials and techniques
- Dental materials
- Orthodontic, periodontal and endodontic esthetics
- Esthetics related research
- Innovations in esthetics